Clinical Pharmacy Activities in Swiss Hospitals: How Have They Evolved from 2013 to 2017?

Studer, Helene; Boeni, Fabienne; Messerli, Markus; Hersberger, Kurt E.; Lampert, Markus L.

doi:10.3390/pharmacy8010019

Cited by 6 publications

(9 citation statements)

References 12 publications

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“…This may be because of a lack of resources. In Swiss hospitals, one will find only 1.12 full-time equivalents for pharmacists per 100 beds [ 12 ]. In addition to the resources, patient-centred services require adequately trained pharmacists to perform these interventions.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the resources, patient-centred services require adequately trained pharmacists to perform these interventions. However, Swiss hospitals only offer 18.5 training positions for the certificate of proficiency in clinical pharmacy, a postgraduate education program focusing on patient-oriented pharmaceutical activities [ 12 ]. Another reason may be that, although medication safety is gaining importance in the Swiss Federal Office of Public Health, there are no legally binding recommendations for Swiss hospitals to implement such services [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…The survey consisted of two parts. The first part described the development of clinical pharmacy services in Swiss hospitals and was published separately [ 12 ]. The second part focused on interventions to improve medication management at hospital discharge.…”

Section: Methodsmentioning

confidence: 99%

“…The questionnaire was accessible from the beginning of June to the beginning of September 2017. Further details were published elsewhere [12]. Table 1.…”

Section: Data Collectionmentioning

confidence: 99%

“…A survey conducted in Swiss hospital pharmacies found an average of 1.12 full-time equivalents of all employed pharmacists per 100 beds, of which 20% were allocated to clinical pharmacy services [ 12 ]. In Switzerland, a hospital pharmacy is an institution that is part of the hospital, managed by a registered pharmacist and offering pharmaceutical services to the hospital’s patients; it is not publicly accessible [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Pharmaceutical Discharge Management: Implementation in Swiss Hospitals Compared to International Guidelines

et al. 2021

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Readmissions to the hospital are frequent after hospital discharge. Pharmacist-led interventions have been shown to reduce readmissions. The objective of this study was to describe pharmacist-led interventions to support patients’ medication management at hospital discharge in Switzerland and to compare them to international guidelines. We conducted a national online survey among chief hospital pharmacists focusing on medication management at hospital discharge. To put our findings in perspective, Cochrane reviews and guidelines were searched for summarised evidence and recommendations on interventions. Based on answers in the survey, hospitals with implemented models to support patients at discharge were selected for in-depth interviews. In semi-structured interviews, they were asked to describe pharmacists’ involvement in the patients’ pathway throughout the hospital stay. In Swiss hospitals (n = 44 survey participants), interventions to support patients at discharge were frequently implemented, mostly “patient education” (n = 40) and “communication to primary care provider” (n = 34). These interventions were commonly recommended in guidelines. Overall, pharmacists were rarely involved in the interventions on a regular basis. When pharmacists were involved, the services were provided by hospital pharmacies or collaborating community pharmacies. In conclusion, interventions recommended in guidelines were frequently implemented in Swiss hospitals, however pharmacists were rarely involved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The questionnaire was accessible from the beginning of June to the beginning of September 2017. Further details were published elsewhere [12]. Table 1.…”

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pharmaceutical Discharge Management: Implementation in Swiss Hospitals Compared to International Guidelines

et al. 2021

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The impact of pharmacist-led medication reconciliation and interprofessional ward rounds on drug-related problems at hospital discharge

et al. 2022

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Background During transitions of care, including hospital discharge, patients are at risk of drug-related problems (DRPs). Aim To investigate the impact of pharmacist-led services, specifically medication reconciliation at admission and/or interprofessional ward rounds on the number of DRPs at discharge. Method In this retrospective, single-center cohort study, we analyzed routinely collected data of patients discharged from internal medicine wards of a regional Swiss hospital that filled their discharge prescriptions in the hospital’s community pharmacy between June 2016 and May 2019. Patients receiving one of the two or both pharmacist-led services (Study groups: Best Care = both services; MedRec = medication reconciliation at admission; Ward Round = interprofessional ward round), were compared to patients receiving standard care (Standard Care group). Standard care included medication history taken by a physician and regular ward rounds (physicians and nurses). At discharge, pharmacists reviewed discharge prescriptions filled at the hospital’s community pharmacy and documented all DRPs. Multivariable Poisson regression analyzed the independent effects of medication reconciliation and interprofessional ward rounds as single or combined service on the frequency of DRPs. Results Overall, 4545 patients with 6072 hospital stays were included in the analysis (Best Care n = 72 hospital stays, MedRec n = 232, Ward Round n = 1262, and Standard Care n = 4506). In 1352 stays (22.3%) one or more DRPs were detected at hospital discharge. The combination of the two pharmacist-led services was associated with statistically significantly less DRPs compared to standard care (relative risk: 0.33; 95% confidence interval: 0.16, 0.65). Pharmacist-led medication reconciliation alone showed a trend towards fewer DRPs (relative risk: 0.75; 95% confidence interval: 0.54, 1.03). Conclusion Our results support the implementation of pharmacist-led medication reconciliation at admission in combination with interprofessional ward rounds to reduce the number of DRPs at hospital discharge.

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Implementation status of safety measures to prevent errors with non-oncologic methotrexate: surveys in community and hospital pharmacies

2023

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Background Accidental overdose of low-dose methotrexate can lead to serious patient harm. Different safety measures are recommended to prevent errors, yet, as errors continue to happen, their implementation is questionable. Aim To evaluate the implementation status of safety measures for methotrexate in community and hospital pharmacies. Method An electronic questionnaire was sent to head pharmacists of 163 community and 94 hospital pharmacies in Switzerland. The implementation of recommended safety measures (general measures, safety working procedures, IT-based measures) was assessed and descriptive analysis performed. An analysis of sales data underlined the relevance of our results, i.e., the population under risk for overdose. Results A response was obtained from 53% (n = 87) of community and 50% (n = 47) of hospital pharmacists. Pharmacies had implemented a median of 6 (IQR 3, community) and 5 (IQR 5, hospital) safety measures overall. Most of these were defined safety procedures, instructing staff on how to handle methotrexate prescriptions. Across all safety measures, compliance with single procedures was perceived as “very likely” by 54% of community pharmacies. IT-based measures (e.g., alerts) were absent in 38% (n = 31) of community and 57% (n = 27) of hospital pharmacies. On average, every community pharmacy dispensed 22 packages annually. Conclusion Safety in relation to methotrexate in pharmacies relies mostly on staff instructions, which are considered weak measures. In light of the serious risk imposed on patients, pharmacies should set a focus on stronger IT-based measures that rely less on human performance.

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Clinical Pharmacy Activities in Swiss Hospitals: How Have They Evolved from 2013 to 2017?

Cited by 6 publications

References 12 publications

Pharmaceutical Discharge Management: Implementation in Swiss Hospitals Compared to International Guidelines

Pharmaceutical Discharge Management: Implementation in Swiss Hospitals Compared to International Guidelines

The impact of pharmacist-led medication reconciliation and interprofessional ward rounds on drug-related problems at hospital discharge

Implementation status of safety measures to prevent errors with non-oncologic methotrexate: surveys in community and hospital pharmacies

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